Evidence map›Paper›PMID 38759489›Full record

ArticleInjury2024

An evaluation of the "Obesity Paradox" in isolated blunt abdominal trauma in the United States.

Kathryn Atkins, Bruce Cairns, Andrew Schneider, Anthony Charles

Abstract read
In one paragraph

Article in Injury, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Electric bicycle versus conventional bicycle crashes: comparative analysis of injury patterns, severity, and the modifying effect of body mass index.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kathryn AtkinsDepartment of Surgery, University of North Carolina at Chapel Hill, USA.
Bruce CairnsDepartment of Surgery, University of North Carolina at Chapel Hill, USA.
Andrew SchneiderDepartment of Surgery, University of North Carolina at Chapel Hill, USA.
Anthony CharlesDepartment of Surgery, University of North Carolina at Chapel Hill, USA. Electronic address: anthchar@med.unc.edu.

Funding

TRAUMA RESEARCH FELLOWSHIPT32GM008450 · NIGMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Bruce A Cairns, Anthony G Charles · 1992 to 2026
$3.8M
NIGMS NIH HHS T32 GM008450
6 · The paper itself

Abstract

backgroundThe obesity paradox theorizes a survival benefit in trauma patients secondary to the cushioning effect of adiposity. We aim to evaluate the impact of body mass index (BMI) on abdominal injury severity, morbidity, and mortality in adults with isolated, blunt abdominal trauma in the United States.

methodsWe reviewed the National Trauma Data Bank (2013-2021) for adults sustaining isolated, blunt abdominal trauma stratified by BMI. We performed a doubly robust, augmented inverse-propensity weighted multivariable logistic regression to estimate the average treatment effect (ATE) of BMI on mortality and the presence of abdominal organ injury.

results36,350 patients met the inclusion criteria. In our study, 41.4 % of patients were normal-weight (BMI 18.5-24.9), 20.6 % were obese (BMI 30-39.9), and 4.7 % were severely obese (BMI≥40). In these cohorts, the abdominal abbreviated injury scale (AIS) was 2 (2 -3). Obese and severely obese patients had significantly reduced presence of pancreas, spleen, liver, kidney, and small bowel injuries. The predicted probability of abdominal AIS severity decreased significantly with increasing BMI. Crude mortality was significantly higher in obese (1.3 %) and severely obese patients (1.3 %) compared to normal-weight patients (0.7 %). Obese and severely obese patients demonstrated non-statistically significant changes in the mortality of +26.4 % (ATE 0.264, 95 %CI -0.108-0.637, p = 0.164) and +55.5 % (ATE 0.555, 95 %CI -0.284-1.394, p = 0.195) respectively, compared to normal weight patients.

conclusionBMI may protect against abdominal injury in adults with isolated, blunt abdominal trauma. Mortality did not decrease in association with increasing BMI, as this may be offset by the increase in co-morbidities in this population.

Indexed as

Abdominal InjuriesBody Mass IndexObesityWounds, NonpenetratingAbbreviated Injury ScaleAdultAgedDatabases, FactualFemaleHumansInjury Severity ScoreMaleMiddle AgedRetrospective StudiesUnited StatesBlunt abdominal traumaCushioning effectObesity paradox

Identifiers

PMID38759489
PMCPMC11179957

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.